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Some shoes can never be filled.

Fam Pract Manag. 2012;19(4):40

Dr. Lima practices at Elma Family Medicine, an affiliate of Mark Reed Hospital, in Elma, Wash., and is an adjunct faculty member at St. Peter Family Medicine Residency in Olympia, Wash. Author disclosure: no relevant financial affiliations disclosed.

More than a year ago, 39-year-old family physician Dr. Mitch Cohen died unexpectedly. He was a devoted family man, a marathon runner, and a skilled family physician with a passion for rural medicine. I was a resident at the time and had been hoping to become one of his partners. In a way, I am.

Working at Dr. Cohen’s rural clinic for more than a year now, I see his patients every day and have witnessed how his legacy has affected this community. Since Mitch was an occasional contributor to Family Practice Management, it seems fitting that he should be acknowledged here.

The clinic has undergone many changes over the past year, some of which were set into motion by Mitch’s efforts. The clinic staff and patients are settling into a new and improved building. The clinic was purchased by the local hospital and obtained its rural health designation. And Mitch’s hopes of an electronic health record are becoming a reality.

While these changes have all been positive, one year later, our practice and our patients still grieve. I have seen numerous patients who couldn’t bear to return to our practice until their prescriptions had run out. One man was in tears as he described the shock of finding out he had outlived his young doctor. He has since been getting into shape by running regularly, inspired by Mitch’s example. One woman said Mitch was like part of her family. Another said she had never felt so understood. “He listened,” said another.

Was Mitch a unique physician? Yes, of course. But he would be overwhelmed to see the grieving patients he has left behind and the impact he has made on his community. As physicians, we often underestimate our influence. A listening ear, a single critical prescription, a friendly face helping to navigate uncharted territory, a word of encouragement – these are the things we do daily that change people’s lives.

Perhaps the most important thing we do as family physicians is to get our patients to come back. Mitch did this well. Patients looked forward to spending time with him. When I saw patients with Mitch, he could tell me their stories because he had taken the time to know their backgrounds, their families, and their motivations. Patients may not have always followed his treatment plans perfectly. But they came back, and each visit brought them one step closer to better health and a better life.

Sometimes I can almost hear Mitch’s voice, especially when I see patients I saw with him during residency. I remember him telling me about the eccentric habits of one patient or the complicated social ties linking others. In many cases, I wish I had listened to him more closely. Now here I am trying to care for them like Mitch did. He was an incredible physician. Amid the chaos of this year-long transition, one thing has become clear to me: I have a lot to live up to.

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